Economic Burden of Measles among Hospitalized Children in Kenya

Measles is endemic in Kenya, mainly affecting young children, with low vaccination coverage leading to recurrent outbreaks. No published study has estimated the cost of treating hospitalised paediatric measles patients in Kenya. This study quantified the cost of treating measles from the healthcare provider and societal perspectives, identified the main cost drivers, and assessed the proportion of households likely to experience catastrophic health expenditure due to the disease. A retrospective, prevalence-based cost-of-illness study was conducted using data from the Clinical Information Network (CIN) for 214 children hospitalised with measles across 16 Kenyan public hospitals from 2013 to 2024. Quantities of resources were extracted from CIN data, and unit costs were obtained from price lists, facility surveys, expert interviews, and market surveys. All costs were converted to 2025 KES and USD. A simulation-based catastrophic health expenditure (CHE) analysis was conducted. One-way sensitivity analysis varied hospital bed, staff, direct non-medical and indirect costs. Median cost per admission was USD 139.11 [IQR: 91.58 to 186.05] (provider) and USD 176.18 [IQR: 116.68 to 256.07] (societal). Staff costs were the primary driver across both perspectives (67% provider, 53% societal), followed by bed days (21% provider, 17% societal). Adjusting the staff time increased treatment costs by 83% (provider) and 73% (societal), while varying bed charges had a lesser effect (-10% to 6% for provider and -3% to 10% for societal). CHE analysis showed that more than half of the households could face catastrophic cost if full treatment costs were paid out-of-pocket. The cost of treating hospitalised paediatric measles patients in Kenya is significant, driven by staff and hospital-bed costs. Policymakers should utilize the evidence generated to expand insurance coverage and refine sub-national resource allocation, to help reduce the catastrophic costs on households and burden on the healthcare system.